Rising cases of needlestick injuries among healthcare workers

By Manika Awasthi and Priya Chetty on May 10, 2022

Needlestick injuries caused due to improper handling of blood collection needles, hypodermic needles, intravenous stiles and needles used for connecting parts of intravenous delivery systems, are the most common occupational hazards among healthcare providers (Norsayani and Hassim, 2003). The occupational exposure of health care personnel to needlestick injuries results in serious infectious complications ranging from mild to extreme health problems (Dhigvijay et al., 2020).

Healthcare providers, due to their occupational exposure to blood and body fluids, are at increased risk of infection by different bloodborne pathogens, such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) (Spruce, 2016).

The rising cases of needlestick injuries across the world

According to WHO estimations, annual exposure of health care providers to bloodborne pathogens was found to be 5.9% for HBV, 2.6% for HCV and 0.5% for HIV, globally (Wicker et al., 2008). In developing countries like India, occupational exposure to needlestick injuries is high, but the majority of them are not reported due to the lack of any national reporting systems. Prevalence of needlestick injury may also be related to the absence of any standard operating protocol in various developing nations. Moreover, emotional distress and fatigue may also be responsible for increased needlestick injuries in developing countries with limited health care workers (Sharma et al., 2010). Thus, needlestick injuries being the common cause of infections among healthcare providers, intervention methods for preventing needlestick injuries and ensuring their safety may be considered the need of the hour.

Causes of needlestick injuries among healthcare workers

Needlestick injuries are found to be mainly caused due to unsafe use of syringe needles, ampoules, hollow bore needles, intravenous cannula and suture needles. The prevalence among healthcare providers has also been contributed to their underreporting by the majority of healthcare workers (Sharma et al., 2010).

During the Covid-19 pandemic, the risky contact of healthcare workers with the Sars-Cov-2 virus and the resulting deaths has given new insights into the significance of occupational protective equipment. The Centre for Disease Control and Prevention has updated ‘Healthcare Infection Prevention and Control Recommendations in Response to COVID-19’ in the healthcare environment. Along with the precautions against diseases transmitted by the respiratory tract, these guidelines also included recommendations against exposure to blood and body fluids and needlestick injuries (Diktas et al., 2021).

However, the results of a few studies showed that needlestick injuries among healthcare workers still occurred in daily practice despite the development and implementation of strict guidelines (Diktas et al., 2021). This proves that the strict regulations taken during the pandemic period have not been sufficient alone to avoid needlestick injuries. Studies also revealed that increasing the use of protective equipment does not fully provide protection (Kakizaki et al., 2011). As a result, many governments have rolled out initiatives for continuous staff training, availability and supervision of preventive protocols that appear as interventions to protect healthcare workers from the risk of bloodborne pathogen infections from needlestick injuries.

Preventive methods healthcare providers

The most essential line of defence against needlestick injuries is considered to be personal protection, like wearing gloves, which is still missing from numerous health care providers. According to studies, more than 75% of the injuries were confessed to be due to self-negligence (Gurung, Paudel and Pun, 2010). The work experience of health care providers has also been found to be a contributing factor in needlestick injuries. Healthcare workers with more experience were found to be more prone to needlestick injuries due to extra years of exposure (Ambad et al., 2021).

Studies have shown a marked decrease in needlestick injuries during the monitored use of needleless systems or use of safer needles and sheathing devices. Most cases of needlestick injuries occur in nurses and hospital staff during the handling and disposal of needles (Archana Lakshmi et al., 2018). Thus, it is the responsibility of healthcare institutions to educate and train their workers about health safety measures. The healthcare institutes should establish an occupational health and safety program along with strict protocols to prevent needlestick injuries.

Occupational health and safety measures are crucial to reduce the risk of occupational exposure to needlestick injuries and transmission of infectious diseases. Overall, the interventions that are considered to be effective include the establishment and implementation of strict health safety policies, maintenance of appropriate safety and organizational culture, standard protocols, regular training on precautionary steps, and regular monitoring of the proper implementation of guidelines.

References

  • Ambad, R.S., Jha, R.K., Bankar, N. and Joshi, A. (2021) ‘A comparative study: incidence of needle stick injury in healthcare personnel’, European Journal of Molecular & Clinical Medicine, 8(1), pp. 363.
  • Archana Lakshmi, P.A., Raja, A., Meriton Stanly, A., Paul, C.M. and Gladius Jennifer, H. (2018) ‘A cross-sectional study on needle stick and sharp injuries among health care providers in tertiary centres, Tamil Nadu’, International Journal of Community Medicine and Public Health, 5(3), pp. 982.
  • Cheng, H.C., Su, C.Y., Yen, A.M. and Huang, C.F. (2012) ‘Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: a nationwide survey’, PLoS One, 7, pp. e34911.
  • Dhigvijay, A., Nirmala, S.V.S.G., Saranya, J., Sivakumar N. and Akhila, K. (2020) ‘Evaluation of cognizance, attitude, and practice of needlestick and sharps injuries among dental health care professionals at Nellore, India – a cross-sectional study, International Journal of Current Research and Review, 12(16), pp. 53-59.
  • Diktas, H., Oncul, A., Tahtasakal, C.A., Sevgi, D.Y., Kaya, O., Cimenci, N., Uzun, N. and Dokmetas, I. (2021) ‘What were the changes during the COVID-19 pandemic era concerning occupational risks among health care workers?’, Journal of Infection and Public Health, 14(10), pp. 1334-1339.
  • Gurung, N.S., Paudel, K. and Pun, C.B. (2010) ‘Needlestick injuries among health care workers in a tertiary care teaching hospital, Pokhara, Nepal’, Journal of Gandaki Medical College, 3, pp. 47-50.
  • Kakizaki, M., Ikeda, N., Ali, M., Enkhtuya, B., Tsolmon, M. and Shibuya, K. (2011) ‘Needlestick and sharps injuries among healthcare workers at public tertiary hospitals in an urban community in Mongolia’, BMC Research Notes, 4, pp. 184.
  • Norsayani, M.Y. and Noor Hassim, I. (2003) ‘Study on incidence of needle stick injury and factors associated with this problem among medical students’, Journal of Occupational Health, 45, pp. 172-178.
  • Sharma, R., Rasania, S.K., Verma, A. and Singh, S. (2010) ‘Study of prevalence and response to needle stick injuries among health care workers in a tertiary care hospital in Delhi, India’, Indian Journal of Community Medicine, 35, pp. 74-77.
  • Spruce, L. (2016) ‘Back to basics: sharps safety’, AORN Journal, 104, pp. 30-36.
  • Wicker, S., Jung, J., Allwinn, R., Gottschalk, R. and Rabenau, H.F. (2008) ‘Prevalence and prevention of needlestick injuries among health care workers in a German university hospital’, International Archives of Occupational and Environmental Health, 81(3), pp. 347-354.

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